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猫咬伤后一名免疫功能正常老年患者发生的脓毒症

Sepsis by in an Elderly Immunocompetent Patient after a Cat Bite.

作者信息

Caserza Lara, Piatti Gabriella, Bonaventura Aldo, Liberale Luca, Carbone Federico, Dallegri Franco, Ottonello Luciano, Gustinetti Giulia, Del Bono Valerio, Montecucco Fabrizio

机构信息

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy.

Ospedale Policlinico San Martino, 10 Largo Benzi, 16132 Genoa, Italy.

出版信息

Case Rep Infect Dis. 2017;2017:2527980. doi: 10.1155/2017/2527980. Epub 2017 Nov 26.

Abstract

colonizes animal scratches and bites. This bacterium was described to cause sepsis or endocarditis mainly in immunocompromised patients. We report the case of a 92-year-old woman presenting at the Emergency Department with coma and fever a week after the bite of her cat. The cat bite was misdiagnosed at admission partly due to an underestimation of this event by the patient's relatives. An inflamed area localized at perimalleolar skin of the right leg was detected. Laboratory biomarkers of inflammation were elevated. The cerebral computed tomography (CT) scan with angiographic sequences showed a complete occlusion of right intracranial vertebral artery. Total body CT scan and abdominal echocardiography were negative for foci of infection. Three consecutive blood cultures were positive for . A diagnosis of sepsis by was made, and the patient recovered after a specific antimicrobial treatment. In order to confirm the animal transmission, the cat saliva was cultured and found positive for with a similar antibiotic sensitivity to that isolated from the patient. In conclusion, the case of a patient with coma and fever after a cat bite was presented. The transmission of pathogens from pets has to be carefully considered as an important route of infection in immunocompetent patients.

摘要

定殖于动物抓伤和咬伤处。这种细菌主要在免疫功能低下的患者中引发败血症或心内膜炎。我们报告了一例92岁女性的病例,她在被猫咬伤一周后因昏迷和发热就诊于急诊科。入院时猫咬伤被误诊,部分原因是患者亲属对该事件重视不足。检查发现右腿踝周皮肤有一处炎症区域。炎症的实验室生物标志物升高。带有血管造影序列的脑部计算机断层扫描(CT)显示右侧颅内椎动脉完全闭塞。全身CT扫描和腹部超声心动图未发现感染病灶。连续三次血培养均对……呈阳性。诊断为……引起的败血症,患者经特异性抗菌治疗后康复。为确认动物传播,对猫唾液进行培养,发现对……呈阳性,其抗生素敏感性与从患者分离出的菌株相似。总之,本文介绍了一例猫咬伤后出现昏迷和发热的患者病例。在免疫功能正常的患者中,必须谨慎考虑宠物传播病原体作为重要感染途径的情况。 (注:原文中部分关键细菌名称等未完整给出,翻译时用“……”表示)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32f/5727562/85ea39eefbeb/CRIID2017-2527980.001.jpg

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